ObjectiveTo review the role of microRNA (miRNA) in skin development and wound healing. MethodsThe recent literature about miRNA in skin development and wound healing was reviewed and analyzed. ResultsmiRNA extensively involved in the development of the skin,including epidermal cell proliferation,differentiation,aging and hair follicle development;miR-203 known as the "skin-specific miRNA" can directly inhibit the expression of p63 and promote the differentiation of the epidermis.Meanwhile,miRNA also involved in various stages of skin regeneration and wound healing.Abnormal expression of miRNA is closely related with abnormal wound healing. ConclusionmiRNA play an important role in maintaining normal skin physiology and skin regeneration.To explore their roles in the healing of skin wounds and their regulatory mechanism can provide a new target for the treatment,which has a potential value and broad prospects.
ObjectiveTo investigate the reliability and validity of Short-Form 36 Health Survey Scale (SF-36) for evaluating quality of life (QOL) of thoracic surgery patients in a specific regional medical center,and improve care and nursing plan for these patients. MethodsNinety-five patients who were admitted in Department of Thoracic Surgery of West China Hospital from March to May 2012 were enrolled in this study. Ninety-four patients finished a valid questionnaire study including 68 male and 26 female patients with their average age of 62.0±13.0 years. Preoperative diagnosis was squamous cell lung cancer in 8 patients,lung adenocarcinoma in 6 patients,small cell lung cancer in 1 patient,esophageal cancer in 12 patients and undefined lung mass in 67 patients. Postoperative diagnosis was squamous cell lung cancer in 39 patients, lung adenocarcinoma in 28 patients,small cell lung cancer in 8 patients,esophageal cancer in 12 patients,pulmonary tuberculosis in 3 patients and inflammatory pseudo-tumor in 4 patients. Chinese edition of SF-36 was used to evaluate patients' QOL. Cronbach's coefficients (α) and split-half reliability were used to assess its reliability. Its validity was assessed through factor analysis. ResultsCronbach's coefficients (α) of SF-36 were as followed:Physical Functioning (PF) 0.721,Role-Physical (RP) 0.859,General Health (GH) 0.721,Vitality (VT) 0.899,Social Functioning (SF) 0.852,Role-Emotional (RE) 0.872,and Mental Health (MH) 0.598. Split-half reliability of each part was PF 0.725,RP 0.784,GH 0.758,VT 0.749,SF 0.745,RE 0.740,and MH 0.426. Nine principal components were extracted by factor analysis and generally reflected the 8 dimensions of SF-36,which was correspondent to the SF-36 structure. ConclusionSF-36 scale can be used to measure QOL of thoracic surgery patients with good reliability and validity.
ObjectiveTo compare clinical results between single and double chest tube applications after lung cancer resection, and explore the role of single chest tube in postoperative fast track recovery. MethodNinety-three patients with lung cancer who underwent lobectomy between March and December of 2009 in West China Hospital of Sichuan University were included in this study. All the patients were divided into a single-tube group including 46 patients (39 males and 7 females) with their age of 58.4±9.5 years, and a double-tube group including 47 patients (32 males and 15 females) with their age of 58.2±9.0 years. Drainage amount, duration, postoperative hospital stay, and incidences of pneumothorax and pleural effusion after removal of chest tubes were compared between the 2 groups. ResultsThe percentage of patients undergoing complete video-assisted thoracic surgery (VATS) of the double-tube group was significantly higher than that of the single-tube group, and the percentage of patients undergoing thoracotomy of the double-tube group was significantly lower than that of the single-tube group (P < 0.05). Drainage amount of the double-tube group was significantly larger than that of the single-tube group (824.4±612.5 ml vs. 510.7±406.7 ml, P < 0.05). There was no statistical difference in drainage duration, postoperative hospital stay, the incidences of subcutaneous emphysema, pneumothorax, pleural effusion or re-insertion of chest drain between the 2 groups (P > 0.05). ConclusionClinical results of single chest tube is better than or equivalent to those of double chest tubes after lung cancer resection, and drainage duration of single chest tube application might be shorter.
ObjectiveTo explore the effect of closed-loop group nursing model on the makeshift intensive care unit (ICU) in a hospital specialized for coronavirus disease 2019 (COVID-19).MethodsSeveral fever wards had been shifted into ICUs and ran by the first medical team from Sichuan Province from January 30th to March 19th, 2020. Closed-loop group nursing model was utilized. The nursing model activated the nurses in management by empowerment and nursing group establishment. To ensure standard of care, measures were carried out in this model, namely, improving the physical work environment, nurse training, optimizing composition of nursing manpower, fine and standardized management of medical resources, “double-chain” medical supply system, “3S” management on first aid kit, protecting patient safety and dignity, and developing emergency nursing workforce deployment plan.ResultsThe implementation of closed-loop group nursing model showed good results in treating severe to critically ill COVID-19 patients regardless of shortages in nursing workforce and facilities. The rescue work was carried out successfully in the makeshift ICUs. All the nurses showed great teamwork and were really involved in the management of the wards. ConclusionsAs the current ICUs were not adequate for the increasing number of critically ill patients during the epidemic, it was unavoidable to transform other wards into ICUs. Closed-loop group nursing model was utilized to break the hierarchy. As a result, all nurses were empowered to participate in nursing management and their potential was fully inspired. Furthermore, this working model presented a clear working framework in multidisciplinary teamwork in a limited time, which also provided patients with dignity and safety.
Objective To explore current view and application status of video-assisted thoracoscopic surgery （VATS） of thoracic surgeons in some municipal hospitals in China，and provide evidence for further VATS study and training.Methods We conducted a questionnaire study for thoracic surgeons in municipal hospitals who attended the 5th West China Forum on Mini-invasive Thoracic Surgery in 2012. The questionnaire content included general descriptions of the thoracic surgeons，the departments of thoracic surgery where they worked，and VATS application status in their hospitals. A total of 263 surgeons were investigated，and 183 （69.58%） valid questionnaires were collected for descriptive analysis.Results （1） Responders’ view of VATS：There were 89.62% （164/183） responders who believed that the advantages of VATS were mainly mini-invasive and fast postoperative recovery，while its disadvantage was high cost （76.50%，140/183）. There were 71.04% （130/183） responders who thought that VATS lobectomy could provide a higher postoperative quality of life for lung cancer patients，while only 12.57% （23/183） responders thought that the 5-year survival rate of VATS was higher than that of open thoracotomy. There were 60.11% （110/183） responders who believed that VATS was less widely performed in China than America，but VATS level of very few hospitals in China was superior or equal to American level. There were 52.46% （96/183） responders who agreed that VATS could be used for the treatment of locally advanced lung cancer. （2） Training situation of VATS lobectomy for lung cancer：Learning class or short-term training （32.24%，59/183） was the best way to learn VATS lobectomy. Their main learning process was from open thoracotomy to mini- thoracotomy then to VATS （60.66%，111/183）. Single-direction thoracoscopic lobectomy was the most popular VATS technique （54.64%，100/183），and its learning curve was at least 30 cases （26.78%，49/183）. （3） VATS application status：VATS was performed in all the hospitals investigated. Benign thoracic diseases were most commonly chosen by thoracic surgeons who started to perform VATS （81.42%，149/183）. The main initial hurdles of VATS lobectomy for lung cancer included poor operation theater conditions and surgical teamwork （39.34%，72/183） as well as unsatisfactory surgical techniques （36.07%，66/183）. Further improvement of VATS technique （118/183，64.48%） was the developmental trend of VATS. Conclusions Thoracic surgeons in China have reached the consensus on the application of VATS for surgical treatment of thoracic diseases including lung cancer. Single-direction thoracoscopic lobectomy is a widely accepted technique. Further trends of VATS training and development are equipment upgrade and better teamwork.
ObjectiveTo observe the possibility and mechanism of microRNA (miRNA)-203 inducing the human epidermal stem cells to differentiate into sweat gland cells. MethodsFive normal human foreskin tissues were harvested to prepare a single cell suspension by 0.25% trypsin-EDTA digestion method, then the human epidermal stem cells were isolated and cultured by type IV collagen differential adherent method. The cell morphology was observed by inverted phase contrast microscope. The monoclonal antibodies of integrin β1 (ITGB1), cytokeratin19 (CK19), CK1, CK10, CK18, and carcinoembryonic antigen (CEA) were used for identification by immunocytochemical staining. Double stranded mimics of has-miR-203 were transfected into the human epidermal stem cells with Lipofectamine 2000 (experimental group) and the human epidermal stem cells transfected with nonsense miRNA mimics served as control group. The monoclonal antibodies of ITGB1, CK19, CK1, CK10, CK18, and CEA were used for identifying the cells after transfection by immunocytochemical staining; the mRNA relative expressions of miRNA-203, P63, ITGB1, CK19, CK1, CK10, CK18, and CEA were detected by real-time fluorescence quantitative RT-PCR before transfected and at 72 hours after transfected. The protein relative expressions of P63, ITGB1, CK19, CK1, CK10, CK18, and CEA were detected by Western blot. The mRNA expression of miRNA-203 and the mRNA and protein expressions of P63 were analyzed respectively with Pearson correlation. ResultsThe CK19 and ITGB1 were positively expressed before transfection, but CK1, CK10, CK18, and CEA were expressed positively after transfection. The mRNA relative expression of miRNA-203 after transfection in experimental group was significantly higher than that before transfection (P<0.05). The mRNA and protein relative expressions of CK1, CK10, CK18, and CEA after transfection in experimental group were significantly higher than those before transfection and control group (P<0.05), while the mRNA and protein relative expressions of P63, CK19, and ITGB1 were significantly lower than those before transfection and control group (P<0.05). These indicators showed no significant difference between the control group and before transfection (P>0.05). The expression level of miRNA-203 was negatively correlated with the mRNA and protein relative expressions of P63 before and after transfection, the correlation coefficients before transfection were -0.91 (t=3.862, P=0.042) and -0.96 (t=5.971, P=0.009) respectively; the correlation coefficients after transfection were -0.92 (t=4.283, P=0.031) and -0.95 (t=5.842, P=0.011) respectively. ConclusionmiRNA-203 can induce epidermal stem cells to differentiate into sweat gland cells by targeting inhibition of P63 probably.